Provider Demographics
NPI:1629885066
Name:TOTTEN, NAKOSHA MARIE (RBT)
Entity type:Individual
Prefix:
First Name:NAKOSHA
Middle Name:MARIE
Last Name:TOTTEN
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 PARLIAMENT PL
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-5664
Mailing Address - Country:US
Mailing Address - Phone:260-487-1526
Mailing Address - Fax:
Practice Address - Street 1:1217 OLD VINES TRL
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-3412
Practice Address - Country:US
Practice Address - Phone:317-533-3507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INBACB1133768106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician